The Human Pain Research Laboratory at Stanford University was created in 1995 by Dr. Martin Angst of the Department of Anesthesiology.  Initial efforts focused on developing reliable methods to quantify pain. With aid of these methods, early research successfully addressed longstanding questions of opioid pharmacology such as tolerance, mode and site of action, and drug-related development of hyperalgesia. In addition to a sustained interest in opioid pharmacology, multiple methods were implemented to evaluate efficacy and potential clinical utility of novel pain therapeutics and interventions.

Today’s studies take advantage of proteomic, genomic, electro-physiological and imaging techniques to delineate new therapeutic pathways, guide clinical development strategies and advance pain therapy.

The Human Pain Research Laboratory hosts multiple collaborative efforts between Dr. Angst and several investigators.  The various approaches taken by these collaborative efforts showcase the multi-facetted interface of modern pain research.  Current studies address:

• Creation of the Stanford Pain Registry, designed to facilitate the discovery of novel solutions for the treatment of chronic pain (Angst, Tingle, Clark)
• Role of beta-adrenergic receptors in modulating pain (Angst, Rohlen, Clark)
• Influence of trans-cutaneous electro-stimulation on pain and cognition (Nekhendzy, Angst)
• Identification of disease and pain-specific biomarkers (Angst, Cueller, Clark and Yeomans)
• Proteomic characterization of nociceptive and inflammatory responses in surgical wounds (Carvalho, Clark and Angst)
• Opioid tolerance and opioid-induced hyperalgesia in chronic pain patients (Chu, Angst and Clark).

The Human Pain Research Laboratory conducts studies under standardized and well controlled conditions generating highly reliable data. In comparison to clinical trials, relatively small set of volunteers or well-characterized pain patients suffice to conduct “proof-of-concept studies”. Such studies are efficient in terms of time and financial expense. They provide pivotal human data guiding the clinical development of novel drug candidates or interventions. Early human data are critical because animal data are quite limited in predicting clinical efficacy.

Experimental pain is evoked in validated models mimicking aspects of acute pain, inflammatory pain, or chronic pain. These pain models are safe and produce reliable and mechanistically meaningful data. Available models include:

• Acute pain (thermal, mechanical, chemical, electrical)
• Inflammatory pain (experimental sunburn, freeze lesion)
• Pain due to central sensitization (capsaicin rekindling, intra-dermal electrical stimulation)

Safe research is a high priority. Subjects’ safety and comfort during experimental procedures is of critical importance to laboratory investigators and staff. Subjects remain in control over the painful stimuli and determine the level of pain to which they are exposed.